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The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
The placenta is fascinating and complex. Basically foreign to the maternal body, it can be thought of as an organ transplanted onto the mother's host tissue. As such it embodies all the principles of tissue acceptance and rejection. Many of the risks of pregnancy and labor have now been eliminated and the placenta is likely to be at the root of many of the dangers to the unborn child that remain. A breakdown of the relationship between the placenta and the maternal tissue may turn out to be the cause of the majority of early lost pregnancies.
Is this a time for a sleeping giant to rise? We have known since study of the lymphocyte and plasma cells really began in earnest in the early 1940's that the pituitary adrenal axis under intimate control of the hypothalamus could influence immunological functions profoundly. We have also known for at least 20 years in my recollection that female sex hor mones can maximize certain immunity functions while male sex hormones tend to suppress many immunological reactions. The thyroid hormones accelerate antibody production while at the same time sp~eding up de gradation of antibodies and immunoglobulins and thyroidectomy decreases the rate of antibody production. Further, much evidence has accumulated indicating that the brain, yes even the mind, can influence in significant ways susceptibility to infections, cancers and to development of a variety of autoimmune diseases. More than 20 years ago, my colleagues and I convinced ourselves, if no one else, that hypnosis can exert major in fluences on the effector limb of the classical atopic allergic reactions. We showed with Aaron Papermaster that the Prausnitz-Kustner reaction may be greatly inhibited, indeed largely controlled, by post-hypnotic suggestion. And it was not even necessary for us to publish our discovery because scientists in John Humphrey's laboratory at Mill Hill Research Center in London had beaten us to the punch. They described hypnotic control of both the PK reaction and delayed allergic reactions to tuberculin by hypnosis.
Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.
As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.
Follow the Hero’s Journey from Pregnancy to Motherhood Filled with unique insights into the spiritual nature of pregnancy, this compassionate guide takes you, the expectant mother, and your loved ones along a “hero’s journey” of discovery. Each trimester correlates to a stage of the epic journey where emotional, spiritual, and physical connections heighten your awareness of yourself and your unborn child. Through these stages, the mundane and everyday are elevated to the sublime and transformative. With their extensive training and experience in allopathic wellness and integrative medicine, Shawn A. Tassone and Kathryn M. Landherr have created a book full of guided meditations, journaling exercises, and spiritual traditions from a variety of cultures. Spiritual Pregnancy also includes yoga postures created by popular doula and pregnant-fit yoga instructor Jennifer (Wolfe) More for specific times throughout pregnancy. Praise: "Spiritual Pregnancy presents birth as the spiritual initiation it truly is. I highly recommend this deeply moving book."—Christiane Northrup, MD, New York Times bestselling author of Women's Bodies, Women's Wisdom and The Wisdom of Menopause “. . . the information shared by the authors will show future mothers how to unify the two lives within them during pregnancy.”—Bernie Siegel, MD, author of Love, Medicine and Miracles “Spiritual Pregnancy is the best guide I know on developing, nourishing, and sustaining [the mother-infant bond].”—Larry Dossey, MD, author of Healing Words “Expert integrative obstetricians, [the authors] guide you through the traditions of the ancients, and illuminate the vibrant path to your own heroine’s journey.” —Victoria Maizes, MD, Executive Director of Arizona Center for Integrative Medicine “From the practical to the profound, I'm confident you will find what you are looking for within this book's pages. I highly recommend it.”—Tieraona Low Dog, MD, Fellowship Director at University of Arizona Center for Integrative Medicine “Spiritual Pregnancy does an incredible job at marrying the physical and the spiritual . . . It will be a great resource to anyone having a baby and it makes me proud to be an ob-gyn.” — Jeniffer Ashton, MD, leading medical correspondent for ABC and ob-gyn physician
A practical manual to aid the management of women with heart disease who are pregnant or who are considering pregnancy, Heart Disease in Pregnancy also provides an introduction to the physiological changes of pregnancy and the relevant obstetric knowledge and processes needed for a cardiologist to successfully manage a pregnant woman.
Book description to come.